Please use this identifier to cite or link to this item:
https://repository.monashhealth.org/monashhealthjspui/handle/1/36761
Conference/Presentation Title: | New strategy to restore erectile function after radical prostatectomy novel minimally invasive end-toside sural nerve grafting procedure. | Authors: | Coombs C.;Reece J.;Dangerfield D. | Institution: | (Dangerfield) Complete Urology Care, Brighton, Australia (Dangerfield) Monash Medical Centre, Clayton, Australia (Coombs) University of Melbourne, Parkvilla, Australia (Reece) University of Melbourne Centre for Cancer Research, Parkvilla, Australia | Presentation/Conference Date: | 6-May-2019 | Copyright year: | 2019 | Publisher: | Blackwell Publishing Ltd | Publication information: | BJU International. Conference: 2019 Annual Scientific Meeting of the Urological Society of Australia and New Zealand. Brisbane, QLD Australia. 123 (Supplement 2) (pp 39), 2019. Date of Publication: April 2019. | Abstract: | Introduction and Objectives: We assessed the potential of innovative nerve grafting surgery to restore erectile function, and improve sexual QoL in men with erectile dysfunction after nerve-, and nonnerve- sparing radical prostatectomy. Method(s): In a retrospective chart review, medical records were abstracted for men who had novel penile reinnervation surgery between 5th March 2015, and May 18th 2017, were < 70 years, and had low comorbidity burden. Novel surgery involved bilateral end-to-side somatic-toautonomic sural nerve grafts from the femoral nerve to the penile corpora cavernosa, with a judicious partial fascicular neurotomy of the femoral nerve. Erectile function, and sexual QoL outcomes were serially assessed using the International Index of Erectile Function (IIEF-5), and sexual domain of the Expanded Prostate Cancer Index Composite (EPIC-26), respectively. The proportion, and corresponding 95% confidence intervals of men with clinically significant outcomes after nerve grafting compared with prior to nerve grafting were determined. Result(s): Prior to nerve grafting surgery, all patients were impotent following their radical prostatectomy. The median age of men at nerve grafting was 64 years (range, 49- 69). The median time between nerve-, and non-nerve-sparing radical prostatectomy, and novel nerve grafting surgery was 2.4 years (range, 1.8-4.3 years), and 2.2 years (range, 0.3-12.9), respectively. Median follow-up was 18 months (range, 12-36). At 12 months post-nerve grafting, 71% (95% CI 44% to 90%) of patients had erectile function recovery sufficient for satisfactory sexual intercourse. In men with restored erectile function, 100% (95% CI 74% to 100%), and 83% (95% CI 52% to 98%) had clinically significant improvements in sexual function, and reduced bother, respectively. Table 3 Proportions of clinically relevant outcomes at 12 months post-nerve grafting compared with pre-nerve grafting. aProportions, and corresponding 95% confidence intervals were calculated using the exact method of Clopper and Pearson.30 (Table presented) Conclusion(s): Innovative minimally invasive end-to-side sural nerve grafting has the potential can restore erectile function, and improve sexual QoL in men with erectile dysfunction following nerve-, or non-nerve-sparing radical prostatectomy. | Conference Start Date: | 2019-04-13 | Conference End Date: | 2019-04-16 | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/bju.14724 | ISSN: | 1464-410X | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/36761 | Type: | Conference Abstract | Subjects: | infant adult aged *cancer surgery child comorbidity controlled study corpus cavernosum erectile dysfunction femoral nerve follow up human International Index of Erectile Function male medical record review middle aged *nerve graft neurotomy *penis erection prostate cancer *prostatectomy reinnervation remission retrospective study school child sexual function sexual intercourse *sural nerve surgery conference abstract comorbidity controlled study corpus cavernosum erectile dysfunction femoral nerve follow up human infant International Index of Erectile Function male medical record review middle aged sexual function sexual intercourse *sural nerve surgery *prostatectomy prostate cancer *penis erection neurotomy *nerve graft adult aged *cancer surgery child school child retrospective study remission reinnervation |
Appears in Collections: | Conferences |
Show full item record
Items in Monash Health Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.